SynthesisBMC nephrology2025
Efficacy and safety of mineralocorticoid receptor antagonists in kidney transplant patients: an updated meta-analysis of randomized controlled trials.
Synthesis in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Finerenone in kidney transplantation: an underinvestigated agent: review of available evidence, existing gaps, and future directions.Clinical transplantation and research · 2026Review
- Heart Failure in Kidney Transplant Recipients: Narrative Review of Risk Factors, Therapy, and Current Gaps in Management.Cardiology and therapy · 2026Review
- What to do with key cardiovascular drugs when kidney function worsens?Clinical kidney journal · 2026Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with chronic kidney disease, mineralocorticoid receptor antagonists (MRAs) exert a reno-protective effect through its anti-inflammatory and antifibrotic effects. Less is known about the efficacy of MRAs in kidney transplant (KT) recipients. This meta-analysis aims to systematically assess the efficacy of MRAs in KT recipients.
methodsPubMed, Embase and Cochrane databases were searched for randomized controlled trials (RCTs) that compared MRAs to placebo in KT recipients and reported the outcomes of (1) glomerular filtration rate (GFR); (2) serum creatinine; (3) systolic (SBP) and diastolic blood pressure (DBP); (4) hyperkalemia; and (5) interstitial fibrosis and tubular atrophy (IFTA) scores. Heterogeneity was examined with I2 statistics. A random-effects model was used for outcomes with high heterogeneity.
resultsWe included 5 RCTs with 293 patients, of whom 142 (48.5%) underwent treatment with a steroidal MRA. Mean follow-up ranged from 5 days to 36 months. There was no significant difference in GFR (MD 9.04 mL/min/1.73 m2; 95% CI - 2.76-20.85; p = 0.13) and serum creatinine between placebo and MRA groups (MD - 0.21 mg/dL; 95% CI - 0.62-0.20; p = 0.32). SBP (MD 0.69 mmHg; 95% CI - 0.69-2.08; p = 0.33), DBP (MD 0.45 mmHg; 95% CI - 0.69-1.59; p = 0.44) and IFTA scores exhibited no differences between groups (mild IFTA RR 1.21; 95% 0.83-1.74; p = 0.32) (moderate IFTA RR 0.82; 95% CI 0.45-1.50; P = 0.51) (severe IFTA RR 0.64; 95% CI 0.24-1.76; p = 0.39). MRAs were associated with a 4-fold increase in the risk of hyperkalemia compared with placebo (RR 4.06; 95% CI 1.46-11.28; p = 0.007).
conclusionSteroidal MRAs have no superior efficacy compared with placebo in KT recipients and are associated with a 4-fold increase in the risk of hyperkalemia despite preserved kidney function. CLINICAL TRIAL NUMBER: Not applicable.
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